Headache

Lore & Background

Headaches are broadly classified as primary or secondary. Primary headaches, which account for ninety percent of all headaches, are benign and recurrent, not caused by underlying disease. Common primary headaches include migraines and tension-type headaches. Migraines typically present with pulsing head pain, nausea, photophobia, and phonophobia, while tension-type headaches present with non-pulsing 'bandlike' pressure on both sides of the head. Other rare primary headaches include cluster headaches, trigeminal neuralgia, hemicrania continua, primary stabbing headache, primary cough headache, primary exertional headache, primary sex headache, and hypnic headache.

Reader's Guide

Secondary headaches are caused by an underlying disease, such as infection, head injury, vascular disorders, brain bleed, or brain tumor, and can be dangerous. Certain 'red flags' indicate a secondary headache may be dangerous. Causes of headaches include dehydration, fatigue, sleep deprivation, stress, medication overuse, recreational drugs, viral infections, loud noises, head injury, rapid ingestion of very cold food or beverage, and dental or sinus issues. Treatment depends on the underlying cause, with pain relievers often used for mild to moderate headaches. The brain itself lacks pain receptors, but pain can be sensed from extracranial arteries, meninges, cranial nerves, and other structures. Primary headaches are more difficult to understand than secondary headaches, and the exact mechanisms causing migraines, tension headaches, and cluster headaches are not known.

Did You Know?

• The brain itself is not sensitive to pain because it lacks pain receptors.
• There is an increased risk of depression in those with severe headaches.
• Tension headaches are the most common type, affecting 24.9% of the population.
• Primary headaches usually first start when people are between 20 and 40 years old.